Sex and Health

The third issue of Buwa! focusses on sex and health in southern Africa as Alice Kanengoni explains in her editorial.

In the last three decades that the African continent has been battling the impacts of HIV and AIDS, a number of positives have been realised. One has been the subject of sex and sexuality finding a somewhat more comfortable place in development discourses on the continent. Sex and sexuality have largely been regarded as issues fit for the private sphere, and in some cases even treated as taboos that are only to be spoken of in hushed tones. The HIV and AIDS movements as well as feminist movements on the continent – and elsewhere – have challenged the notion of sex as a private matter, and brought it into discourses on health, economics, politics and power, thus firmly establishing it as a rights issue.

Two recent global platforms have been quite telling in this regard. The 12th AWID International Forum in Istanbul in April 2012, under the theme Transforming Economic Power to Advance Women’s Rights and Justice had a significant number of sessions focusing on sex, sexuality, sex work, pleasure and their intersections with economics and money as well as politics and power. Meanwhile, in May, the Open Society Africa Foundations convened the OpenForum – an equally diverse platform whose theme focused on money, power and sex. What was most striking for me at both events was the significant space given to sex and sexuality on their programmes; and I thought to myself, the continent has indeed come far!

This Issue of BUWA! carries African voices and stories, unpacking and sharing experiences in sex and health, and highlighting trends, realities, opportunities and challenges. Although sex has arguably firmly taken root in health and rights discourses, this has not been without challenges. Dr Vicci Tallis and Laura Washington illuminate some of these challenges and contentions in a piece that locates the sexual and reproductive health rights discourse in the broader feminist struggle for women’s sexuality rights and emancipation.

Given the tendency – dictated by culture and tradition – to confine sex and sexuality to the private sphere, HIV and AIDS discourses have managed to break that artificial wall, bringing issues of sex and sexuality into the public sphere, albeit as health and reproductive health and rights issues. Thus, it has been largely HIV and AIDS movements that have led the southern Africa region in pushing an agenda for sexual and reproductive health rights. A number of significant gains have been recorded on this front – key among them being finding space for sex, sexuality and reproductive health rights on public agendas and dialogues. It is precisely because of this important step forward that global forums discussing so-called hard issues of economic transformation, money and power could legitimately and confidently engage with issues of sex and sexuality. However, most sex and health rights movements in the region are still struggling – like women’s movements generally – and the challenge remains to continue strengthening these movements to ensure that these critical issues remain in the public domain and are not relegated once again to the private sphere.

Another gain has been on the steady traction towards gaining autonomy over women’s bodies. During the decades spent fighting HIV and AIDS on the continent, it has become clear how women’s vulnerabilities are increased by a lack of real choice in relation to protection, treatment and care. Practices such as lobola, as discussed by Takunda Chabata, have become a key part of the debate with lobola being viewed as giving men the right to decide how and when married women can have sex. A woman’s right to choose even in issues of contraception becomes compromised in this regard.

As such, married women tend to be more vulnerable, and have less control over their bodies, than their unmarried counterparts. The space to negotiate safe and enjoyable sex in a marriage context tends to be more limited. This is even more pronounced in countries where there are many different marriage regimes, creating challenges for women. For instance, customary law marriages allow men to have more than one spouse, increasing women’s vulnerability to HIV and AIDS. Some of the challenges are articulated by Sibusisiwe Ndlovu-Bhebe, who argues that there is a need to harmonise Zimbabwe’s marriage laws to make it easier for women. Emmah Machokoto’s poem aptly summarises how marriage increases women’s vulnerability.

A review of policy and legislative frameworks in southern Africa in relation to women’s bodily integrity paints a picture of a region that offers half measures; where laws and policies do not fully guarantee women choices regarding their bodies. Issues of abortion, sex work and sterilisation are cases in point. Namuchana Mushabati highlights some of the shortfalls in her analysis of policy trends in Zambia. These gaps often result in backstreet abortions, which have taken the lives of many women, as illustrated by Karina Dulobo and Mazuba Haanyama in their analysis of the role that the family unit has played in denying women, particularly young women, their right to bodily integrity.

However, it is not only the family that has helped men to maintain their control over women’s bodies, but also health care institutions. In southern Africa, especially in Namibia, South Africa and Botswana, there have been reports of the forced sterilisation of HIV positive women by medical doctors. In Namibia, a few cases have been brought before the courts but these are – almost certainly – just the tip of the iceberg in what is suspected to be a systematic and widespread practice that violates women’s reproductive health rights. There is suspicion that this practice might also be happening in other countries in the region, and there is need for research and provision of safe spaces that allow for women to open up and share their experiences.

The education system has also not been sensitive to school-going girls’ sexuality and reproductive health rights as Stella Jerop Chebiiillustrates in her case study of how a lack of access to sanitary towels had been a barrier to adolescent girls accessing education in urban slums in Kenya.

On the African continent women are not encouraged to enjoy sex, and the reasons for this are often rooted in culture, tradition and religion. Some religions have been manipulated to deny women the right to enjoyable sex as Grace Chirenje and Brian Nachipo demonstrate based on their observations of how some Christian Scriptures are cited out of context to control women’s access to contraception and good, safe and enjoyable sex. Sex, in their observation, is interpreted as primarily for procreation, and not for enjoyment, and pleasure is regarded as the preserve of men. This is not just in the context of religion, but also in the context of culture and tradition, as Tinashe Mema and Rudo Chigudu argue.

The notion of sex being for men’s pleasure also manifests in Africa in the form of female genital mutilation (FGM). A number of cultures promote various forms of FGM, which in some cases has serious consequences on the reproductive health of the women. A number of research initiatives and documentation of the dangers and injustices of such practices have been done on the continent, and one such book by Marie-Helene Mottin-Sylla and Joelle Palmieri is discussed in this Issue by Mazuba Haanyama, who questions, among other things, the notion of labelling such practices as ‘mutilation’.

Sian Maseko contends that because sex and pleasure are often defined in the context of hetero-normativity, the tendency is to adopt a moralistic attitude towards sex outside of marriage. In particular, same sex relationships are criminalised in most countries in the region.

Another way in which women’s bodies have been controlled is through rape. Although rape is recognised as a crime in southern Africa, certain types of rape are often ignored, as Gemma Hancox argues in her piece, which decries the prevalence of marital rape in South Africa in spite of laws and policies that are designed to protect women. Similarly, rape targeted at lesbians and transgender people purportedly to ‘correct’ them is also becoming prevalent in the region, as shown by Tiffani Wesley, who makes a case for such rape to be classified as a hate crime.

Control of the woman’s body is also linked to who defines beauty – and how it is defined. Societal standards of beauty have created an industry that controls women’s hair, skin, size, shape and looks; all driven by a capitalist ethos, which is the bedrock of patriarchy. Davina Jogi highlights this in her powerful photo-essay from Zimbabwe.

However, there are some positive moves towards giving women more control over their bodies. In particular, strides have been made in research towards preventive tools with regards to HIV and AIDS. Groundbreaking microbicide trials are a case in point. Pauline Irungu sheds light on how the African continent is at the brink of delivering on the 20-year-old dream of providing women with access to vaginal microbicides, a form of protection they hopefully will be able to control. But even with such breakthroughs, there is still the need to develop a culture of respect for the sexual and reproductive health rights of women – and it is necessary to start fostering this culture at lower levels of the education system, as exemplified by Lerissa Thaver and Astrid Leao in their case study of South African secondary schools.

For decades, women have been organising, coalescing and building movements to resist all forms of oppression – including denial of their sexuality and reproductive health rights. These efforts need to be captured and documented, as in the case of the publication African Women Writing Resistance: Contemporary Voices (Edited by Jennifer Browdy de Hernandez, Pauline Dongala, Omotayo Jolaosho and Anne Sarafin), which is reviewed Dr Hleziphi Naomie Nyanungo.

We hope this Issue of BUWA! challenges African women and men to continue loosening the lid that has been kept tightly shut for decades to prevent issues of sex and sexuality from being openly discussed – and in the process making women and girls more vulnerable and putting their lives at risk.

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